Utility of right ventricular free wall speckle-tracking strain for evaluation of right ventricular performance in patients with pulmonary hypertension

Yuko Fukuda, Hidekazu Tanaka, Daisuke Sugiyama, Keiko Ryo, Tetsuari Onishi, Hiroyuki Fukuya, Munenobu Nogami, Yoshiharu Ohno, Noriaki Emoto, Hiroya Kawai, Ken Ichi Hirata

Research output: Contribution to journalArticle

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Abstract

Background: The objectives of this study were to test the utility of right ventricular (RV) speckle-tracking strain as an assessment tool for RV function in patients with pulmonary hypertension (PH) compared with conventional echocardiographic parameters and to investigate the relationship of the findings obtained with RV speckle-tracking strain with the hemodynamic parameters of RV performance. Methods: Forty-five prospective consecutive patients with PH were studied. RV free wall longitudinal speckle-tracking strain (RV-free) and RV septal wall longitudinal speckle-tracking strain (RV-septal) were calculated by averaging each of three regional peak systolic strains along the entire right ventricle. The conventional echocardiographic parameters - RV fractional area change, RV myocardial performance index, tricuspid annular plane systolic excursion, and tricuspid annular peak systolic velocity - were also studied. For comparison, 22 age-matched volunteers with normal ejection fractions were studied. Results: RV-free in patients with PH was significantly lower than that in normal controls, but RV-septal in the two groups was similar. Importantly, multivariate analysis revealed that RV-free was an independent echocardiographic predictor of hemodynamic RV performance items, including mean pulmonary artery pressure (β = -0.844, P =.001) and pulmonary vascular resistance (β = -0.045, P <.001). RV-free was also correlated with RV ejection fraction and RV end-systolic volume measured by cardiac magnetic resonance imaging and with 6-min walking distance (r = 0.60, r = 0.56, and r = 0.49, respectively, P <.05). Furthermore, the improvement in RV-free 5 ± 3 months after adding medical treatment was significantly correlated with that in 6-min walking distance (r = 0.68, P <.0001). Conclusions: RV-free has the potential to allow for noninvasive follow-up of patients with PH.

Original languageEnglish
Pages (from-to)1101-1108
Number of pages8
JournalJournal of the American Society of Echocardiography
Volume24
Issue number10
DOIs
Publication statusPublished - 2011 Oct
Externally publishedYes

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Pulmonary Hypertension
Stroke Volume
Walking
Hemodynamics
Right Ventricular Function
Vascular Resistance
Pulmonary Artery
Heart Ventricles
Healthy Volunteers
Multivariate Analysis
Magnetic Resonance Imaging
Pressure
Therapeutics

Keywords

  • Echocardiography
  • Pulmonary hypertension
  • Right ventricular performance
  • Right ventricular speckle-tracking strain

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Utility of right ventricular free wall speckle-tracking strain for evaluation of right ventricular performance in patients with pulmonary hypertension. / Fukuda, Yuko; Tanaka, Hidekazu; Sugiyama, Daisuke; Ryo, Keiko; Onishi, Tetsuari; Fukuya, Hiroyuki; Nogami, Munenobu; Ohno, Yoshiharu; Emoto, Noriaki; Kawai, Hiroya; Hirata, Ken Ichi.

In: Journal of the American Society of Echocardiography, Vol. 24, No. 10, 10.2011, p. 1101-1108.

Research output: Contribution to journalArticle

Fukuda, Yuko ; Tanaka, Hidekazu ; Sugiyama, Daisuke ; Ryo, Keiko ; Onishi, Tetsuari ; Fukuya, Hiroyuki ; Nogami, Munenobu ; Ohno, Yoshiharu ; Emoto, Noriaki ; Kawai, Hiroya ; Hirata, Ken Ichi. / Utility of right ventricular free wall speckle-tracking strain for evaluation of right ventricular performance in patients with pulmonary hypertension. In: Journal of the American Society of Echocardiography. 2011 ; Vol. 24, No. 10. pp. 1101-1108.
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AU - Fukuda, Yuko

AU - Tanaka, Hidekazu

AU - Sugiyama, Daisuke

AU - Ryo, Keiko

AU - Onishi, Tetsuari

AU - Fukuya, Hiroyuki

AU - Nogami, Munenobu

AU - Ohno, Yoshiharu

AU - Emoto, Noriaki

AU - Kawai, Hiroya

AU - Hirata, Ken Ichi

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N2 - Background: The objectives of this study were to test the utility of right ventricular (RV) speckle-tracking strain as an assessment tool for RV function in patients with pulmonary hypertension (PH) compared with conventional echocardiographic parameters and to investigate the relationship of the findings obtained with RV speckle-tracking strain with the hemodynamic parameters of RV performance. Methods: Forty-five prospective consecutive patients with PH were studied. RV free wall longitudinal speckle-tracking strain (RV-free) and RV septal wall longitudinal speckle-tracking strain (RV-septal) were calculated by averaging each of three regional peak systolic strains along the entire right ventricle. The conventional echocardiographic parameters - RV fractional area change, RV myocardial performance index, tricuspid annular plane systolic excursion, and tricuspid annular peak systolic velocity - were also studied. For comparison, 22 age-matched volunteers with normal ejection fractions were studied. Results: RV-free in patients with PH was significantly lower than that in normal controls, but RV-septal in the two groups was similar. Importantly, multivariate analysis revealed that RV-free was an independent echocardiographic predictor of hemodynamic RV performance items, including mean pulmonary artery pressure (β = -0.844, P =.001) and pulmonary vascular resistance (β = -0.045, P <.001). RV-free was also correlated with RV ejection fraction and RV end-systolic volume measured by cardiac magnetic resonance imaging and with 6-min walking distance (r = 0.60, r = 0.56, and r = 0.49, respectively, P <.05). Furthermore, the improvement in RV-free 5 ± 3 months after adding medical treatment was significantly correlated with that in 6-min walking distance (r = 0.68, P <.0001). Conclusions: RV-free has the potential to allow for noninvasive follow-up of patients with PH.

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